<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0874-0283</journal-id>
<journal-title><![CDATA[Revista de Enfermagem Referência]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Enf. Ref.]]></abbrev-journal-title>
<issn>0874-0283</issn>
<publisher>
<publisher-name><![CDATA[Escola Superior de Enfermagem de Coimbra - Unidade de Investigação em Ciências da Saúde - Enfermagem]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0874-02832021000300016</article-id>
<article-id pub-id-type="doi">10.12707/rv20145</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Adesão terapêutica: contributos para a compreensão e intervenção]]></article-title>
<article-title xml:lang="en"><![CDATA[Therapeutic adherence: contributions to understanding and intervention]]></article-title>
<article-title xml:lang="es"><![CDATA[Adherencia terapéutica: contribuciones a la comprensión e intervención]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camarneiro]]></surname>
<given-names><![CDATA[Ana Paula Forte]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Escola Superior de Enfermagem de Coimbra Unidade de Investigação em Ciências da Saúde: Enfermagem ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>serV</volume>
<numero>7</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0874-02832021000300016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0874-02832021000300016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0874-02832021000300016&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Enquadramento:  A adesão terapêutica (AT) visa a melhor saúde dos indivíduos e populações, reveste-se de grande complexidade e é influenciada por múltiplos fatores. As taxas de não-adesão continuam demasiado elevadas, sendo importante melhor conhecer para intervir.  Objetivos:  Analisar conceitos de AT; refletir sobre fatores associados à AT; sistematizar estratégias de intervenção; compreender métodos de avaliação.  Principais tópicos em análise:  A AT, enquanto comportamento do utente, é esperada como resposta às recomendações/prescrições dos profissionais de saúde, após cooperação mútua. A motivação do utente para ultrapassar barreiras à mudança de comportamento mostra-se fundamental. O utente é tomado como corresponsável pelo tratamento. Os profissionais de saúde adotam estratégias de promoção da AT em prol dos utentes, mobilizando-os. Serviços e políticas de saúde apoiam a minimização dos obstáculos e incentivam a avaliação da AT para melhorar práticas.  Conclusão:  A AT é multifatorial, o que dificulta o processo. Para o êxito da AT é necessária coordenação exemplar de todos os atores envolvidos, utentes, profissionais de saúde e instâncias sociais e políticas, antecipando medidas adequadas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background:  Therapeutic adherence (TA) aims to improve the health of individuals and populations. It is highly complex and influenced by multiple factors. Non-adherence rates are still excessively high, and it is important to know more about them to intervene.  Objectives:  To analyze concepts of TA, reflect on factors associated with TA, systematize intervention strategies, and understand assessment methods.  Main topics under analysis:  As part of patient behavior, TA is the expected outcome of health professionals&#8217; recommendations/prescriptions, following mutual cooperation. Patient motivation is essential to overcome barriers to behavioral change, and patients are considered co-responsible for their treatment. Health professionals adopt TA promotion strategies to benefit and mobilize users. Health services and policies support the minimization of obstacles and encourage the evaluation of TA to improve practices.  Conclusion:  TA is multifactorial, which makes the process more difficult. Successful TA requires coordinating all involved stakeholders - users, health professionals, and social and political bodies, by anticipating the appropriate measures.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Marco contextual:  La adherencia terapéutica (AT) tiene como objetivo mejorar la salud de los individuos y las poblaciones, es muy compleja y está influida por múltiples factores. Las tasas de no adherencia siguen siendo demasiado elevadas, y es importante comprenderlas mejor para poder intervenir.  Objetivos:  Analizar los conceptos de AT; reflexionar sobre los factores asociados a la AT; sistematizar las estrategias de intervención; comprender los métodos de evaluación.  Principales temas en análisis:  La AT, como comportamiento del usuario, se espera como respuesta a las recomendaciones/prescripciones de los profesionales de la salud, tras una cooperación mutua. La motivación del usuario para superar las barreras al cambio de comportamiento es esencial. El usuario se considera corresponsable del tratamiento. Los profesionales sanitarios adoptan estrategias de promoción de la AT en favor de los usuarios y los movilizan. Los servicios y las políticas sanitarias apoyan la minimización de los obstáculos y fomentan la evaluación de la AT para mejorar las prácticas.  Conclusión:  La AT es multifactorial, lo que complica el proceso. El éxito de la AT requiere una coordinación ejemplar de todas las partes interesadas, los usuarios, los profesionales sanitarios y los organismos sociales y políticos, y anticipar así las medidas adecuadas.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[adesão terapêutica]]></kwd>
<kwd lng="pt"><![CDATA[não-adesão terapêutica]]></kwd>
<kwd lng="pt"><![CDATA[tratamento]]></kwd>
<kwd lng="pt"><![CDATA[intervenção]]></kwd>
<kwd lng="pt"><![CDATA[avaliação]]></kwd>
<kwd lng="en"><![CDATA[treatment adherence and compliance]]></kwd>
<kwd lng="en"><![CDATA[patient non-adherence]]></kwd>
<kwd lng="en"><![CDATA[treatment]]></kwd>
<kwd lng="en"><![CDATA[intervention]]></kwd>
<kwd lng="en"><![CDATA[evaluation]]></kwd>
<kwd lng="es"><![CDATA[adherencia terapéutica]]></kwd>
<kwd lng="es"><![CDATA[incumplimiento terapéutico]]></kwd>
<kwd lng="es"><![CDATA[tratamiento]]></kwd>
<kwd lng="es"><![CDATA[intervención]]></kwd>
<kwd lng="es"><![CDATA[evaluación]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Adams]]></surname>
<given-names><![CDATA[G. C.]]></given-names>
</name>
<name>
<surname><![CDATA[Skomro]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Wrath]]></surname>
<given-names><![CDATA[A. J.]]></given-names>
</name>
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[L. A.]]></given-names>
</name>
<name>
<surname><![CDATA[Le]]></surname>
<given-names><![CDATA[T.]]></given-names>
</name>
<name>
<surname><![CDATA[Fenton]]></surname>
<given-names><![CDATA[M. E.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The relationship between attachment, treatment compliance and treatment outcomes in patients with obstructive sleep apnea]]></article-title>
<source><![CDATA[Journal of Psychosomatic Research]]></source>
<year>2020</year>
<numero>137</numero>
<issue>137</issue>
</nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cabral]]></surname>
<given-names><![CDATA[M. V.]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[P. A.]]></given-names>
</name>
</person-group>
<source><![CDATA[A adesão à terapêutica em Portugal: Atitudes e comportamentos da população portuguesa perante as prescrições médicas]]></source>
<year>2010</year>
<publisher-name><![CDATA[Imprensa de Ciências Sociais]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Camarneiro]]></surname>
<given-names><![CDATA[A. P.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Em torno da adesão aos protocolos terapêuticos]]></article-title>
<source><![CDATA[Referência]]></source>
<year>2002</year>
<numero>9</numero>
<issue>9</issue>
<page-range>25-30</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Coelho]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Vilares]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Gordicho]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Caetano]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Investigação sobre adesão à terapêutica na população portuguesa: Uma revisão de âmbito]]></article-title>
<source><![CDATA[Revista Portuguesa de Medicina Geral Familiar]]></source>
<year>2017</year>
<numero>33</numero>
<issue>33</issue>
<page-range>262-76</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Eindhoven]]></surname>
<given-names><![CDATA[D. C.]]></given-names>
</name>
<name>
<surname><![CDATA[Hilt]]></surname>
<given-names><![CDATA[A. D.]]></given-names>
</name>
<name>
<surname><![CDATA[Zwaan]]></surname>
<given-names><![CDATA[T. C.]]></given-names>
</name>
<name>
<surname><![CDATA[Schalij]]></surname>
<given-names><![CDATA[M. J.]]></given-names>
</name>
<name>
<surname><![CDATA[Borleffs]]></surname>
<given-names><![CDATA[C. J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Age and gender differences in medical adherence after myocardial infarction: Women do not receive optimal treatment: The Netherlands claims database]]></article-title>
<source><![CDATA[European Journal of Preventive Cardiology]]></source>
<year>2018</year>
<volume>25</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>181-9</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fernandez-Lazaro]]></surname>
<given-names><![CDATA[C. I.]]></given-names>
</name>
<name>
<surname><![CDATA[García-González]]></surname>
<given-names><![CDATA[J. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Adams]]></surname>
<given-names><![CDATA[D. P.]]></given-names>
</name>
<name>
<surname><![CDATA[Fernandez-Lazaro]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
<name>
<surname><![CDATA[Mielgo-Ayuso]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
<name>
<surname><![CDATA[Caballero-Garcia]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Racionero]]></surname>
<given-names><![CDATA[F. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Cordova]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Miron-Canelo]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adherence to treatment and related factors among patients with chronic conditions in primary care: Across-sectional study]]></article-title>
<source><![CDATA[BMC Family Practice]]></source>
<year>2019</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>132</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gorczynski]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[H.]]></given-names>
</name>
<name>
<surname><![CDATA[Ganguli]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adherence to diabetes medication in individuals with schizophrenia: A systematic review of rates and determinants of adherence]]></article-title>
<source><![CDATA[Clinical Schizophrenia &amp; Related Psychoses]]></source>
<year>2017</year>
<volume>10</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>191-200</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Haynes]]></surname>
<given-names><![CDATA[R. B.]]></given-names>
</name>
<name>
<surname><![CDATA[Taylor]]></surname>
<given-names><![CDATA[D. W.]]></given-names>
</name>
<name>
<surname><![CDATA[Sackett]]></surname>
<given-names><![CDATA[D. L.]]></given-names>
</name>
</person-group>
<source><![CDATA[Compliance in health care]]></source>
<year>1979</year>
<publisher-name><![CDATA[Johns Hopkins University Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Horne]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Chan]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Wileman]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adherence to treatment]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Revenson]]></surname>
<given-names><![CDATA[T.]]></given-names>
</name>
<name>
<surname><![CDATA[Gurung]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<source><![CDATA[Handbook of psychology]]></source>
<year>2019</year>
<page-range>148-61</page-range><publisher-name><![CDATA[Taylor and Francis]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kini]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
<name>
<surname><![CDATA[Ho]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Interventions to improve medication adherence: A review]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2018</year>
<volume>320</volume>
<numero>23</numero>
<issue>23</issue>
<page-range>2461-73</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Linn]]></surname>
<given-names><![CDATA[A. J.]]></given-names>
</name>
<name>
<surname><![CDATA[Weert]]></surname>
<given-names><![CDATA[J. C.]]></given-names>
</name>
<name>
<surname><![CDATA[Gebeyehu]]></surname>
<given-names><![CDATA[B. G.]]></given-names>
</name>
<name>
<surname><![CDATA[Sanders]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Diviani]]></surname>
<given-names><![CDATA[N.]]></given-names>
</name>
<name>
<surname><![CDATA[Smit]]></surname>
<given-names><![CDATA[E. G.]]></given-names>
</name>
<name>
<surname><![CDATA[Dijk]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Patients&#8217; online information-seeking behavior throughout treatment: The impact on medication beliefs and medication adherence]]></article-title>
<source><![CDATA[Health Communication]]></source>
<year>2019</year>
<volume>34</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1461-8</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[A. J.]]></given-names>
</name>
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[J. P.]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[S. A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adesão ao regime medicamentoso antes e após intervenção de sensibilização terapêutica]]></article-title>
<source><![CDATA[Revista de Enfermagem Referência]]></source>
<year>2017</year>
<volume>4</volume>
<numero>14</numero>
<issue>14</issue>
<page-range>9-16</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Matsuzawa]]></surname>
<given-names><![CDATA[Y.]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[Y.]]></given-names>
</name>
<name>
<surname><![CDATA[Fraser]]></surname>
<given-names><![CDATA[F.]]></given-names>
</name>
<name>
<surname><![CDATA[Langenbahn]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
<name>
<surname><![CDATA[Shallcross]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Powers]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Lipton]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Simon]]></surname>
<given-names><![CDATA[N.]]></given-names>
</name>
<name>
<surname><![CDATA[Minen]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Barriers to behavioral treatment adherence for headache: An examination of attitudes, beliefs, and psychiatric factors]]></article-title>
<source><![CDATA[Headache]]></source>
<year>2019</year>
<volume>59</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>19-31</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meichenbaum]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
<name>
<surname><![CDATA[Turk]]></surname>
<given-names><![CDATA[D. C.]]></given-names>
</name>
</person-group>
<source><![CDATA[Facilitating treatment adherence: A practitioner&#8217;s guidebook]]></source>
<year>2012</year>
<edition>2</edition>
<publisher-name><![CDATA[Springer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Monterroso]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
<name>
<surname><![CDATA[Pierdevara]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
<name>
<surname><![CDATA[Joaquim]]></surname>
<given-names><![CDATA[N.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Avaliação da adesão regime terapêutico dos utentes seguidos na consulta externa de psiquiatria do centro hospitalar barlavento algarvio]]></article-title>
<source><![CDATA[Revista Portuguesa de Enfermagem de Saúde Mental]]></source>
<year>2012</year>
<numero>7</numero>
<issue>7</issue>
<page-range>39-45</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ogden]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<source><![CDATA[Psicologia da saúde]]></source>
<year>2004</year>
<edition>2</edition>
<publisher-name><![CDATA[Climepsi]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Panesar]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Patient compliance and health behavior models]]></article-title>
<source><![CDATA[U.S. Pharmacist]]></source>
<year>2012</year>
<volume>37</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>12-4</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez-Jover]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
<name>
<surname><![CDATA[Sala-González]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Guilabert]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Mira]]></surname>
<given-names><![CDATA[J. J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mobile apps for increasing treatment adherence: Systematic review]]></article-title>
<source><![CDATA[Journal of Medical Internet Research]]></source>
<year>2019</year>
<volume>21</volume>
<numero>6</numero>
<issue>6</issue>
</nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="">
<collab>World Health Organization</collab>
<source><![CDATA[Adherence to long-term therapies: Evidence for action]]></source>
<year>2003</year>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
